The Little Sisters of the Poor vs. Obamacare

Under the Affordable Care Act, most employers are required to provide their employees with health insurance that covers birth control.

Under the Affordable Care Act, most employers are required to provide their employees with health insurance that covers birth control. (Los Amgeles Times)

The Times editorial board

The Little Sisters of the Poor, an organization of Roman Catholic nuns that runs nursing homes around the country, is testing the contraceptive coverage mandate of the Affordable Care Act. Last week, we're sorry to say, the nuns won a temporary reprieve from Supreme Court Justice Sonia Sotomayor.

Under the law, most employers are required to provide their employees with health insurance that covers birth control. But the Obama administration agreed to a compromise for nonprofit religious groups that object to contraception, exempting them from paying for such coverage. Instead, insurers agreed to absorb the cost. All the religious organization has to do is fill out a simple form attesting to its situation.

Unfortunately, even that was too much for the Little Sisters of the Poor.

The group's objection to filling out the form is hard to fathom, as is Sotomayor's baffling decision to block the requirement until the case can be considered on its merits. The Little Sisters' case hangs on the absurd argument that the simple act of filling out the form — the whole point of which is to guarantee its freedom from the mandate — somehow represents a "substantial burden" on its exercise of religion.

The form couldn't be easier or shorter. It takes five minutes to fill out and sign.

The nuns also argue that if they fill out the form, thereby allowing coverage through a third party, they would in effect be encouraging someone else to sin. But that's not true in this particular case because the Little Sisters of the Poor offers health coverage through a religious insurer that is itself exempt from providing contraceptive services. So even if the nuns sign the form, employees still won't receive the coverage.

And even if the group was using a non-religious insurer, and even if that insurer provided the coverage, we still wouldn't buy the argument. The compromise was designed to ensure that a religious charity wouldn't have to pay for coverage it objects to. That others might ultimately pay for the coverage isn't the charity's business.

One disconcerting possibility is that religiously-affiliated nonprofits might circumvent the intent of the mandate by expanding the role of nonprofit religious insurance organizations like the one the Little Sisters uses. That would be an extreme measure to avoid an aspect of healthcare reform that is meant to allow employees to make their own medical decisions. But it could work.